Hello, 

Our network of outpatient infusion centers is noticing an increase in ADRs with carboplatin (domestic products, not imported from China). We were wondering if the timing of our premedications had any effect. We give our premeds early in the process and patients may get other therapies prior to getting their carbo dose.

How far in advance does your facility administer its premedications? 

Thank you, 

Miheret Tesfaye

Our organization emphasized safety as the organization's number one goal this year, and increasing good catch reporting is part of this initiative. Our department has struggled between what a good/great catch is vs. an intervention that is part of the pharmacist's role in the med use process and decreasing preventable harm.

What is your criteria for a good/great catch in your organization?

Hi,

Is anyone using Mini bag plus with liquid vials such as metoprolol or tranexamic acid? If so, can you share any stability/compatibility data to support its use?

Thank you,
Amirah

Aassabahi@holyname.org

Hi All,
Do you prepare Sodium Bicarb 150 mEq/1,000 mL infusions using sterile water as a carrier solution? If so, do you dispense the final product in the SWFI original container or pump it into an empty bag?

Chris

I screened historical topics but am not finding what I am looking for so will bring back the topic of patient own medications for hospital setting.

1) Does your organization allow for patients to bring in their own controlled substances for hospital setting (when not on formulary)?
2) If so, how are these handled? Do patients sign anything to state that they are handing over their CS for hospital use? Are they stored in an automated dispensing cabinet or in a locked med drawer? Is a daily count completed?

Hi All
We are in the process of updating/reviewing our override list and are trying to determine which poractant (surfactant) size - 120mg/1.5ml or 240 mg/3 mL should be on override. We currently have both products on override and would like to streamline down to 1 available on override but are getting some pushback. I'm trying to determine what is most common for other institutions to have on override. We are a referral center with a 40+ bed NICU.

What are others doing for 3+ drug y-site compatibility? Trissel's chart reflects only 2 drug compatibility regardless of how many drugs are entered and shown and cannot run an analysis on 3 drugs. The company is aware of display limitations but confirmed that compatibility between A+B, B+C, and A+C DOES NOT necessarily mean that A+B+C are compatible. Any suggestions for running 3+ drugs together?

For those that allow range orders, is the limit of the dose range defined in policy? For example, ranges are limited to 2-3 times the lowest dose (e.g., morphine 2-4mg IV q2h prn pain). Are there different limits for opioids versus non-opioids? Are orders such as sliding scale insulin or alcohol withdrawal carved out as they tend to have wider ranges but include clearly defined parameters (e.g., doses based on blood sugars or CIWA scores)?

Any input would be greatly appreciated.

Thanks in advance!
Amanda

We use CADD pumps and ever since the bag spike change (March) we have seen an increase in reported events of the pump infusing air into the epidural space. Sometimes the reservoir volume has been programmed incorrectly and sometimes the bag spike has not been fully inserted. We are considering enabling the air-in-line setting to catch these errors sooner. Curious how your organizations have approached these settings. Thank you!

I've read through the discussions about methotrexate at physician offices which has led to more questions about other HDs. We own about 12 physician practices - these physician practices are not provider based clinics so they don't really fall under my radar of oversight. With USP 800 however, I feel obligated to provide some oversight on how to handle the HDs at the offices. Also, the drugs used at our physician offices are purchased by us, the hospital pharmacy, and we distribute to each practice requesting them.